Contractures, a tendency for muscles, tendons or scar tissue to shorten in skeletal joints, are common after trauma and represent a major challenge in the care of such injuries. Routine and occupational tasks can be severely hindered by flexion-extension contractures of the humeral-ulnar joint as well as supination-pronation contractures of the proximal radial-ulnar joint which controls rotational motion of the radius about the axis of the ulna.
Current approaches to the treatment of forearm trauma have more aggressively sought to prevent contracture and stiffness through movement. Methods of rigid internal fixation with sufficient stability to allow motion within days after injury rather than closed treatment and immobilization in a cast have been developed. In the treatment of dislocations, protected early motion is now begun as soon as the patient is comfortably able to do so.
However, the currently available techniques for the prevention and treatment of contracture are not uniformly successful. Early active motion alone can reduce the severity of contracture, but requires the patient's own strength, compliance and constant effort. Dynamic splints may be used, but these require pressure on the sometimes sensitive or injured soft tissues of the arm and forearm and thus may reduce patient compliance, or may not be possible to use, i.e., in burn injury. Additionally, fractures of the proximal radius that require distraction have been treated in the past with simple pin fixation holding the ulna fixed to the radius. While fixed to the ulna, contracture and loss of motion occur.
What is needed are improved methods of preventing and/or treating tissue contractures. In addition, what is needed are improved devices useful in preventing and/or treating tissue contractures.